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Intellectual function after treatment for leukaemia or solid tumours.

V Twaddle, P G Britton, A C Craft

    Archives of Disease in Childhood
    |December 1, 1983
    PubMed
    Summary
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    Children treated for acute lymphoblastic leukaemia (ALL) experienced significant intellectual deficits, especially in higher cognitive functions, following cranial irradiation and chemotherapy. Solid tumour patients showed less severe, time-diminishing deficits.

    Area of Science:

    • Neuroscience
    • Pediatric Oncology
    • Developmental Psychology

    Background:

    • Cancer treatments like cranial irradiation and chemotherapy can impact cognitive development in children.
    • Long-term intellectual outcomes for pediatric cancer survivors require thorough investigation.

    Purpose of the Study:

    • To assess and compare intellectual functioning in children treated for acute lymphoblastic leukaemia (ALL) versus solid tumours (ST).
    • To investigate the relationship between treatment modalities (cranial irradiation, chemotherapy) and intellectual deficits.
    • To evaluate the timing and progression of cognitive deficits post-treatment.

    Main Methods:

    • Intellectual evaluation using British Ability Scales in 23 ALL patients and 19 ST patients.
    • Comparison with a control group of siblings, with statistical adjustments for pre-morbid functioning.

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  • Analysis of treatment details including cranial irradiation, intrathecal, and systemic chemotherapy.

    • Main Results:

    • Both ALL and ST patient groups exhibited intellectual deficits post-treatment.
    • ALL patients demonstrated more pronounced intellectual deficits, particularly in higher cognitive functions.
    • Deficits in ALL patients emerged progressively after radiotherapy, especially in younger children; ST deficits diminished over time.

    Conclusions:

    • Cranial irradiation and chemotherapy for ALL are associated with significant, progressive intellectual deficits.
    • Cognitive sequelae differ between ALL and ST treatment protocols, with younger age at treatment being a critical factor for ALL.
    • Further research is needed to understand and mitigate long-term cognitive impacts in pediatric cancer survivors.